Provider Demographics
NPI:1275175275
Name:WILLOW SPRINGS COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:WILLOW SPRINGS COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL BUSTO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:479-652-6611
Mailing Address - Street 1:204 N FRONT ST STE A
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-3843
Mailing Address - Country:US
Mailing Address - Phone:479-355-1606
Mailing Address - Fax:479-782-5502
Practice Address - Street 1:105 N FRONT ST
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-3821
Practice Address - Country:US
Practice Address - Phone:479-355-1606
Practice Address - Fax:479-782-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health